In the past decade, two advances have made the acquisition of listening skills and intelligible speech by individuals with hearing loss more attainable. The first is universal newborn hearing screening and the second is cochlear implantation (CI). 90% of children who receive a CI before they are 18 months old attain intelligible speech. However, intensive aural (re)habilitation training is crucial for these children and other individuals who receive CI's to fully realize the benefit of a cochlear implant. Face-to-face training with a speech and language pathologist is expensive, time-consuming, and may not always be available because clients may live in rural areas where there are no specialists, or children may be placed in public schools without in-house AR specialists. There are several aural (re)habilitation tools available commercially that can be self-administered. Many of these are specifically designed for adult speakers. One tool that is available for children is the Listening Skills Tutor developed by researchers at the Center for Spoken Language Understanding (CSLU) at Oregon Health & Science University and specialists at the Tucker-Maxon Oral School. In Phase I, we will significantly expand the capabilities of this Listening Skills Tutor (LST) and evaluate its performance. The most important improvement of the LST is that it will contain adaptive computer-guided lessons for a wide variety of phoneme listening targets, allowing hearing-impaired individuals to attain listening skills without the extensive guidance of a specialist. In addition, the new system presents phoneme listening targets with improved speech (either natural or improved synthetic voice); uses image alternatives in addition to, or instead of, word alternatives; and uses a natural as opposed to a synthetic talking face. In this Phase I-STTR project we will focus on phonetic discrimination and identification skill building. In Phase II, we will expand the LST to include suprasegmental targets and global comprehension activities. Supra-segmental targets include pitch and pitch contours, amplitude, and speech rate. Global comprehension includes understanding words in conversation and will be presented in quiet and adverse listening conditions such as in noise or with competing conversations (babble). In addition, in Phase II we will build a computer-based assessment tool which will determine what specific targets users need to learn. The assessment tool will use an up-down methodology of testing (or staircase method) which determines the entry level of users based on a selective number of stimuli. PUBLIC HEALTH RELEVANCE In the United States, roughly 22,000 adults and nearly 15,000 children have received cochlear implants and these individuals need intensive auditory (re)habilitation (AR) training to fully realize the potential benefit of a cochlear implant and attain intelligible speech. Face-to-face AR training with a specialist is expensive, not always covered by insurance and not always feasible because clients may live in rural areas where there are no specialists, or children may be placed in public schools without in-house AR specialists. Therefore, a computer-guided program that allows auditory training without the help of a specialist is necessary. The proposed project will create and evaluate such a program, focusing on learning phoneme discrimination and identification. It uses natural and high-quality synthetic voices, displays choice alternatives with child- appropriate pictures, and has a natural talk-face option. [unreadable] [unreadable] [unreadable]